Course Application Form

Every student must fill the Application Form to sign up for the course.

Course Application Form

Your answers on this Application Form are important to determine your acceptance for the desired course(s).

Select course(s) that you would like to apply for: *

According to our course schedule, which dates do you want to do the course?: *

First Name: *

Last name: *

E-mail: *

Phone:

Age: *

Date of Birth: *

Gender (Male/Female): *

Street:

City:

ZIP:

Country: *

Do you want to do this course as a hobby, vocation or as a profession in massage & bodywork?: *

Write atleast a few lines on what you would like to gain from doing this course: *

Have you ever practiced massage before? If yes, what massages have you practiced before?: *

Please list all previous experience or training in massage therapy, including names of schools and dates attended: *

How long have you been practicing?:

Have you studied Anatomy / Physiology?: *

What are you doing currently?: *

Do you have any injuries or medical conditions we should know about?: *

Are you currently taking any medication? If yes, please list: *

How did you hear about us?: *

Are you a returning student?: *

Have you visited India before?:

Any questions or comments:

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* These fields are required.

(NOTE: If you are unable to fill this application form online, please write to us: info@aitheinhealing.com)

Please fill out the Application Form below in as much details as possible and Submit it to us. This will begin the application process. Your answers on the Application Form will help us determine if you currently possess the qualifications necessary to enter the courses. If so, we will then guide you through the enrollment process.

By submitting this application, you would have stated that you have completed this application to the best of your knowledge, and that the information you have provided is true and correct.